“Years ago it meant something to be crazy; now everyone’s crazy.”
I recalled these words during a recent episode at work in which a surgical colleague suddenly threw his hands in the air, folded his arms, and asked me point-blank, “Hey, man, why is the world so crazy these days?”
It was an honest question, and the complex, though incomplete, answer I had in my head, one I have been formulating for years—Western society has fundamentally evolved from a repressive 19th- and early 20th-century climate of hysteria-neuroses to a latter-day fragmented-identity climate of narcissism-borderline—came out instead as a butchered line from another, albeit fictional, psychopath, Norman Bates, “Hey, we all go a little crazy . . . sometimes” (Psycho, Universal Studios film; 1960).
Both Manson, in California, and Bates, on film, have been subjected to old-fashioned “moral treatment” for their “madness”: isolation from polite society. But this seems out of step with the National Institute of Mental Health’s fairly newly adopted classification of “crazy” as essentially biological.2 Indeed, every time I read the updated Research Domain Criteria (RDoC) manifestos I cannot help but recall the infamous bio-behavioral “re-programming” of the protagonist, Alex, in Stanley Kubrick’s 1971 film version of Anthony Burgess’ dystopian A Clockwork Orange. For those unfamiliar with the sequence, the “ultraviolent” nature of this delinquent youth is “cured” with an experimental biological “treatment”: subjecting him forcibly to watching hours of rough-cut violent imagery, set to Beethoven’s Ninth Symphony, while some unspecified emetic drug is injected into his veins. Afterward even the thought of violence causes horrific visceral reactions in Alex, thereby molding his behavior very much against his will, but allowing him re-entry to polite society.
Dr Martin is a Pediatric and Adult Consultation-liaison Psychiatrist at the Newton-Wellesley Hospital in Newton, MA, and a Clinical Assistant Professor of Psychiatry at Tufts University School of Medicine in Boston. He reports no conflicts of interest concerning the subject matter of this article.
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